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MBA /BBA/ BCA Admission form

INSTITUTE FOR INSPIRATION & SELF DEVELOPMENT
Name (In Block Letters) :
Father’s Name :
Mother’s Name :
Permanent Address :
 
PIN Phone No.
Mobile No.    
Present Address :
 
Phone No. (R) Office:
E-mail :    
Date of Birth:
(Attach Age Proof)		 dd / mm /YYYY
Nationality:
Course (s) to be applied for:
MBA BBA BCA
Category :
Gen SC ST OBC
Attach No Objection Certificate or Police Clearance Certificate, if not Indian citizen
Languages Known (Specify Mother Tongue)
Educational Qualification :
EXAMINATION NAME OF
INSTITUTION		 NAME OF BOARD
UNIVERSITY /
COUNCIL		 YEAR OF
PASSING		 STREAM %
10 TH / EQUIV.
10 + 2 / EQUIV.
GRADUATION
MASTERS
OTHERS
Source from which you came to know about the institute, News paper / others (please specify)
Working Experience (Please Tick) :
Yes No
If yes, Name & Address of the Organization :
Preferred Timing for the class (Please Tick) :
Morning Day Evening Week ends and Holidays
Declaration
1. I herby declare that the information provided by me is true and subject to verification by IISD/ PTU.
2. I herby confirm that I have seen, read and completely understood the rules and regulationsand other information as supplied in the IISD admission prospectus, before my admission.
3. I hereby agree to follow all the rules and regulations as specified in the Student Handbook or
any other document, which may be modified from time to time, if I am granted admission.
4. The Admission Committee’s decision is final and binding on the applicant in matters of
admission to the respective courses.